Appointment Request

Please complete the form below to schedule an appointment.  I will be in touch within 48 business hours. An appointment will be scheduled after a brief conversation to ensure that I am the best fit for your needs.

By submitting this form via this web portal, you acknowledge and accept that risks of communicating your health information via this unencrypted email and electronic messaging and wish to continue despite those risks. By clicking "Yes, I want to submit this form" you agree to hold Brighter Vision harmless for unauthorized use, disclosure, or access of your protected health information sent via this electronic means. *